Skin replacement with a collagen based dermal substitute, autologous keratinocytes and fibroblasts in burn trauma

Wisser, D.; Steffes, J

doi:10.1016/s0305-4179(03)00013-5

Cited by 83 publications

(42 citation statements)

References 6 publications

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“…In otherwise healthy adults with burns, this process is repeated during several successive operative procedures until the entire burn wound has undergone debridement and secondary covering with new skin grafts. However, skin substitutes may be used for resurfacing in burn patients who have limited skin graft donor sites because of the extent of the injury (52,53,198,225,230,293,460).…”

Section: Early Excision and Burn Wound Closurementioning

confidence: 99%

Burn Wound Infections

Church

Elsayed

Reid³

et al. 2006

Clin Microbiol Rev

1,595

1,345

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SUMMARYBurns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Significant thermal injuries induce a state of immunosuppression that predisposes burn patients to infectious complications. A current summary of the classifications of burn wound infections, including their diagnosis, treatment, and prevention, is given. Early excision of the eschar has substantially decreased the incidence of invasive burn wound infection and secondary sepsis, but most deaths in severely burn-injured patients are still due to burn wound sepsis or complications due to inhalation injury. Burn patients are also at risk for developing sepsis secondary to pneumonia, catheter-related infections, and suppurative thrombophlebitis. The introduction of silver-impregnated devices (e.g., central lines and Foley urinary catheters) may reduce the incidence of nosocomial infections due to prolonged placement of these devices. Improved outcomes for severely burned patients have been attributed to medical advances in fluid resuscitation, nutritional support, pulmonary and burn wound care, and infection control practices.

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Section: Early Excision and Burn Wound Closurementioning

confidence: 99%

Burn Wound Infections

Church

Elsayed

Reid³

et al. 2006

Clin Microbiol Rev

1,595

1,345

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“…Experimental studies indicate that the incorporation of dermal substitutes is improved by the seeding with mesenchymal stem cells, keratinocytes and adipose tissue-derived microvascular fragments (ad-MVF) (Wisser and Steffes, 2003;Trottier et al, 2008;Frueh et al, 2017a). Of interest, ad-MVF can be isolated in large amounts from fat tissue within a short time and represent fully functional vessel segments (Frueh et al, 2017b).…”

Section: Introductionmentioning

confidence: 99%

Seeding density is a crucial determinant for the in vivo vascularisation capacity of adipose tissue-derived microvascular fragments

Später

Körbel

Frueh

et al. 2017

eCM

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Adipose tissue-derived microvascular fragments (ad-MVF) represent effective vascularisation units for the seeding of dermal substitutes. However, particularly in case of extensive skin defects, the required amounts of donor fat tissue for the harvesting of ad-MVF may not always be available. Therefore, we herein determined the lowest ad-MVF density needed to induce a sufficient vascularisation and incorporation of seeded implants. Collagen-glycosaminoglycan matrices (Integra ® ; diameter: 4 mm) were seeded with 15,000 (HD), 10,000 (MD) and 5,000 (LD) ad-MVF and implanted into full-thickness skin defects within mouse dorsal skinfold chambers, to analyse their in vivo vascularisation and incorporation. Intravital fluorescence microscopy showed a comparable vascularisation of HD and MD ad-MVF-seeded Integra ® , which was significantly higher when compared to LD ad-MVF-seeded Integra ® . As assessed by photoacoustic imaging, this was associated with an increased oxygenation of the implants. Additional histological and immunohistochemical analyses revealed an enhanced cellular infiltration, collagen content, microvessel density and epithelialisation of HD and MD ad-MVF-seeded Integra ® , indicating a better incorporation compared to LD ad-MVF-seeded implants. These findings demonstrate that 80,000 ad-MVF/cm² is the least required density to guarantee an effective vascularisation of the dermal substitute.

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“…1 However, the most successful applications have been limited to thin avascular tissues such as skin and cartilage 2,3 in which delivery of nutrients and oxygen relies on diffusion. To overcome the diffusion limit, a functional vascular network must be created to deliver blood to the inner part of the tissue quickly upon implantation.…”

Section: Introductionmentioning

confidence: 99%